一项针对中国女性艾滋病毒携带者/艾滋病患者的污名化干预的效果：一项随机临床试验

IF 4.9 2区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Social Science & Medicine Pub Date : 2025-04-14 DOI:10.1016/j.socscimed.2025.118072

Zhongfang Yang , Shuyu Han , Xiang Qi , Jing Wang , Zhijing Xu , Weiyu Mao , Yaguang Zheng , Yue Zhang , Bei Wu , Yan Hu

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引用次数: 0

摘要

背景：尽管有证据支持针对文化的干预措施在减少耻辱感方面的有效性，但在中国，这种方法对感染艾滋病毒/艾滋病的妇女（WLWHAs）缺乏。我们进行了这项研究，以确定文化定制的帮助克服耻辱感（hope）干预在减少中国wlwha的耻辱感方面的效果。方法于2023 - 2024年在中国南方和西南地区进行单盲、双平行组随机临床试验。使用嵌入微信的随机化应用程序将来自四家医院的wlwha分配到对照组（常规护理）或hope干预组。数据分析师仍然是盲目的。使用“不让任何人掉队”（Leave No One Behind， LNOB）平台进行干预，为期3个月。在基线、干预后和干预后3个月，使用HIV/AIDS污名体验问卷（HASEQ）中的7个项目评估主要结局——感知污名得分，并通过重复测量分析对数据进行分析。结果在筛选的136例WLWHAs中，我们随机选取了101例(50例；51控制)。霍普组在干预后立即显示出具有统计学意义的耻辱感得分下降(- 3.86分，95% CI: 5.34至- 2.38,P <；.001)和干预后3个月(- 5.83点，95% CI: 7.20至- 4.47,P <；.001)。结论研究结果表明，hope在减少WLWHA患者的耻辱感方面具有疗效。然而，这些变化的临床意义有待进一步研究。未来的研究应侧重于定义有意义的患者报告阈值，评估长期影响，并优化给药方法。

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Efficacy of a culturally tailored intervention on perceived stigma among women living with HIV/AIDS in China: A randomized clinical trial

Background

Despite evidence supporting the efficacy of culturally tailored interventions in reducing stigma, such approaches are lacking for women living with HIV/AIDS (WLWHAs) in China. We conducted this study to determine the efficacy of the culturally tailored Helping Overcome Perceived Stigma (HOPES) intervention in reducing perceived stigma among WLWHAs in China.

Methods

A single-blinded, two-arm parallel-group randomized clinical trial was conducted from 2023 to 2024 in South and Southwest China. WLWHAs from four hospitals were assigned using a WeChat-embedded randomization application to the control group (usual care) or the HOPES intervention. Data analysts remained blinded. Interventions were conducted virtually using Leave No One Behind (LNOB) platform for 3 months. The primary outcome, perceived stigma score, was assessed at baseline, immediately after the intervention and at 3 months post-intervention using 7 items from the HIV/AIDS Stigma Experience Questionnaire (HASEQ), with data analyzed through repeated measures analysis.

Results

Of 136 WLWHAs screened, we randomized 101 WLWHAs (50 HOPES; 51 controls). The HOPES group demonstrated a statistically significant reduction in perceived stigma scores immediately after the intervention (−3.86 points, 95 % CI: 5.34 to −2.38, P < .001) and at three months post-intervention (−5.83 points, 95 % CI: 7.20 to −4.47, P < .001) compared to the control group.

Conclusion

The findings demonstrate HOPES' efficacy in reducing perceived stigma in WLWHA. However, the clinical significance of these changes needs further investigation. Future research should focus on defining meaningful patient-reported thresholds, assessing long-term impact, and optimizing delivery methods.

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来源期刊

Social Science & Medicine PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-

CiteScore

9.10

自引率

5.60%

发文量

762

审稿时长

38 days

期刊介绍： Social Science & Medicine provides an international and interdisciplinary forum for the dissemination of social science research on health. We publish original research articles (both empirical and theoretical), reviews, position papers and commentaries on health issues, to inform current research, policy and practice in all areas of common interest to social scientists, health practitioners, and policy makers. The journal publishes material relevant to any aspect of health from a wide range of social science disciplines (anthropology, economics, epidemiology, geography, policy, psychology, and sociology), and material relevant to the social sciences from any of the professions concerned with physical and mental health, health care, clinical practice, and health policy and organization. We encourage material which is of general interest to an international readership.